A bluish color to the skin or mucous membrane is usually due to a lack of oxygen in the blood. The medical term is cyanosis.
Lips - bluish; Fingernails - bluish; Cyanosis; Bluish lips and fingernails; Bluish skin
Red blood cells provide oxygen to body tissues. Most of the time, nearly all red blood cells in the arteries carry a full supply of oxygen. These blood cells are bright red and the skin is pinkish or red.
Blood that has lost its oxygen is dark bluish-red. People whose blood is low in oxygen tend to have a bluish color to their skin. This condition is called cyanosis.
Depending on the cause, cyanosis may develop suddenly, along with shortness of breath and other symptoms.
Cyanosis that is caused by long-term heart or lung problems may develop slowly. Symptoms may be present, but are often not severe.
When the oxygen level has dropped only a small amount, cyanosis may be hard to detect.
In dark-skinned people, cyanosis may be easier to see in the mucous membranes (lips, gums, around the eyes) and nailbeds.
People with cyanosis do not normally have anemia (low blood count). Anemia is a condition in which the body does not have enough healthy red blood cells.
Cyanosis that is seen in only one part of the body may be due to:
Most cyanosis occurs because of a lack of oxygen in the blood. This can be caused by the following problems.
Problems with the lungs:
Problems with the airways leading to the lungs:
Problems with the heart:
For cyanosis caused by exposure to cold or Raynaud phenomenon, dress warmly when going outside or stay in a well-heated room.
Most other acute episodes of cyanosis need to be diagnosed and treated by a health care provider (office or emergency room).
Bluish skin can be a sign of many serious medical problems. Contact or visit your provider.
For adults, contact your provider or call the local emergency number, such as 911 if you have bluish skin and any of the following:
For children, contact your provider or call 911 or the local emergency number if your child has bluish skin and any of the following:
In general, cyanosis that occurs acutely is more likely to be an emergency than when it is present for a long time.
Your provider will perform a physical examination. This will include listening to your breathing and heart sounds. In emergency situations (such as shock), you will be stabilized first.
The provider will ask about your symptoms. Questions may include:
Tests that may be ordered include:
The treatment you receive depends on the cause of cyanosis. For example, you may receive oxygen for shortness of breath.
McGee S. Cyanosis. In: McGee S, ed. Evidence-Based Physical Diagnosis. 5th ed. Philadelphia, PA: Elsevier; 2022:chap 9.
Shetty P, Fernández-Frackelton M. Cyanosis. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 10.
Reviewed By: Denis Hadjiliadis, MD, MHS, Paul F. Harron, Jr. Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.